714
THE NEW ZEALAND GAZETTE.

[CIRCULAR.]

Downing Street, 4th September, 1873.
SIR,—In my Circular Despatch of the 28th of De-
cember, 1870, I invited your Government, in common
with those of other Colonies, to contribute to the
expense of sending Dr. Gavin Milroy to the West
Indies in order to investigate the treatment of
leprosy which was then being pursued by the late
Dr. Beauperthuy, and which had attracted wide
attention both there and in Europe.

2. The Colonies responded liberally to this invita-
   tion, and Dr. Milroy, who was thus enabled to
   pursue his inquiry with the deliberation which its
   importance deserved, has submitted to me a Report
   narrating his proceedings, and setting forth the con-
   clusions at which he has arrived on the questions
   referred for his consideration. Copies of that Report
   have already been supplied to you from this Depart-
   ment, and I have now to convey to you the observa-
   tions and instructions which it has suggested to me.

3. Dr. Beauperthuy died shortly after Dr. Milroy's
   arrival at Kaon Island, in British Guiana; and by
   this untimely event, Dr. Milroy lost the advantage
   of observing the course of Dr. Beauperthuy's treat-
   ment as conducted by himself. You will observe
   with regret that Dr. Milroy's Report does not record
   any instance of the success of Dr. Beauperthuy's
   treatment in effecting the actual cure of leprosy.

4. The value of Dr. Beauperthuy's treatment is a
   question for the medical profession, and I have at
   present no further instructions to give you respecting
   it than that you should place the information which
   Dr. Milroy's Report affords in the possession of the
   medical men practising in the Colony under your
   Government, for which purpose you shall either be
   supplied with additional copies of the Report or with
   extracts of it reprinted in a pamphlet form, as may
   be hereafter decided.

5. You may be aware that Dr. Milroy was a
   member of the Committee appointed by the Royal
   College of Physicians, in 1863, to investigate the
   subject of leprosy. In their Report (published in
   1867), that Committee expressed a very decided
   opinion, adverse to the popular belief that leprosy
   was contagious. Dr. Milroy's recent researches ap-
   pear to have strongly confirmed him in the opinion
   which he expressed as one of the Committee; and I
   hope that his Report (which contains in an Appendix
   a reprint of the conclusions of the Committee) may
   tend to reassure those who entertain apprehensions
   on the subject.

6. He rejects the theory that leprosy is the result
   of a communicable blood-poison like syphilis, and
   defines it as "a constitutional cachexy or an un-
   healthy condition, not of any one part or texture of
   the body, but of its whole framework or system"
   (page 37); and he indicates, as the chief promoting
   causes of this cachexy, malaria and insufficient and
   unwholesome food.

7. The people in the West Indies, through
   ignorance, neglect the use of the vegetables which
   the resources of the country supply. They also do
   not use cereals and rice; the price of these articles,
   however, in some degree explains their neglect.
   Fresh meat is not sold at prices which bring it
   within their reach, and their only nitrogenized food
   is salt meat or salt fish, which they appear to prefer
   in a state of putrescence.

8. In some Colonies the tariff may be so arranged
   that the people are tempted to abandon the more
   nutritious for the less nutritious kinds of food. Any
   fiscal advantages which involved such consequences
   would be dearly bought; and it will be your duty to
   consider whether the tariff of your Colony is free
   from objection in this respect.

9. Beyond readjusting the tariff upon sound prin-
   ciples (if such should be necessary), the Government
   of a Colony cannot directly deal with the question of
   the food of the people. But it may properly call
   the attention of employers to the subject, and suggest
   co-operation amongst themselves for the improve-
   ment of the diet of persons employed by them. It
   is obvious that they have a deep interest in the
   question, and their position enables them to exercise
   an important influence upon the population generally
   in this matter.

10. In a Despatch which Dr. Milroy has printed
    as an Appendix, the Governor of Trinidad has sug-
    gested the introduction of goat's flesh as an article of
    food. The use of this meat and of Australian pre-
    served meat, in the public institutions which Govern-
    ment controls, might tend in time to diffuse a
    wholesome demand amongst the general population
    for these articles of food. The sale of putrescent
    fish could no doubt be prevented by law, but I am
    not at present prepared to express an opinion in
    favour of such a measure. If the popular taste for
    food in an advanced stage of decomposition is as
    inveterate as it is represented to be, the people
    would defeat the law by keeping, until deteriorated,
    provisions which they had purchased when fresh. I
    should be glad to be favoured with any observations
    you may be able to offer on the whole question.

11. .I have to request your special attention to the
    remarks of Dr. Milroy on the various Leper Asylums
    which he visited. The Governor of the Colony in
    which each of these asylums is situated, is responsible
    for taking early measures for removing the particular
    evils which Dr. Milroy has pointed out as existing in
    the asylum of his Colony ; but you will perceive that
    besides drawing attention to deficiencies in particular
    institutions, Dr. Milroy has indicated fully what in
    his opinion are the requirements of such institutions.

12. They should be not merely asylums but
    hospitals, in the full sense of the term, having an
    organized staff of nurses commensurate with their
    scale, and having at command the services of one or
    more medical officers attending with frequency and
    regularity. They should be large enough to admit
    of their atmosphere being kept pure and wholesome,
    and they should be in a situation free from malaria.

13. The diet should be ample; and as salt pro-
    visions are deemed to be amongst the exciting causes
    of the disease, these should be systematically ex-
    cluded, as in Trinidad, from the diet.

14. With regard to the internal discipline of the
    asylums, the males should be kept as far as practicable
    separate from the females, and the youths from the
    men; and as idleness has an injurious and depressing
    effect upon the patients, all who are not bed-ridden
    or totally disabled should be provided with occu-
    pation according to their capacity for work.

15. You will ascertain and report to me how far
    the asylum in the Colony under your Government
    satisfies the requirements here indicated; and if it
    falls short in any particulars, what measures you
    propose for remedying its deficiencies.

16. The disease of Yaws, which is described in the
    latter part of Dr. Milroy's Report, appears to be
    entirely distinct from leprosy. It has in a great
    measure disappeared since emancipation, but has a
    tendency to reappear in an epidemic form from time
    to time. In its nature it appears to run a regular
    course, to be curable, and to be more or less
    contagious.

17. You will observe that Dr. Milroy is not in-
    clined to agree with the view that leprosy may be
    propagated by means of vaccine lymph, even when
    blood has been mixed with the lymph. However, as
    the success of a system of vaccination must largely
    depend upon the views prevailing amongst the public